My journey into learning disability nursing started at an early age when I worked
voluntarily with children who had complex disabilities and were staying in the respite
care environment, where I volunteered. My passion for working with people with
learning disabilities continued as I undertook nurse ‘training’ in a large long-stay
hospital and faced challenges on a daily basis to the way I felt care should be
delivered. Over the years I worked with many nurses who, like me, were constrained
by an environment of routine and order, one which often disempowered both the
nurses and those that lived in that environment. However, I was also supported in
this environment, feeling part of a ‘community’ and feeling privileged to share the
day-to-day lives of people with learning disabilities. I began my nurse training in the
early 1980s at a time when there had been a major challenge to the role of the
learning disability nurse from the Briggs report (1972) and the Jay Report (1979).
The Briggs report had suggested a new professional grouping and Jay had
suggested replacing nurses with workers who held a social care-based qualification.
Each decade post Jay brought with it a challenge to the role of the learning disability
nurse. A letter from the Chief Nursing Officer (CNO) in 1985 reinforced the commitment to maintaining the role and status of the learning disability nurse
(Mitchell, 2000). The 1990s also brought with it a change in the emphasis in role of
the learning disability nurse, the Cullen report (1991) suggested a greater emphasis
for learning disability nurses on the health rather than social care needs of those with
learning disabilities – a move towards health – and this has been further supported by
a number of reports as the focus on the role of the nurse has re-emerged in health.
This focus has been reinforced by a number of reports that have acknowledged the
health needs of people with learning disabilities who have moved from institutions
and into community-based living.
With this background, learning disability nurses have been debating their role within
the nursing profession since (Mitchell, 2003). Some 30 years later, in 2001, the
Government produced its White Paper Valuing People First (DH, 2001) where there
is little mention of specific services, but the notion of inclusion and the use of generic
services is clear and part of the guiding principles of this White Paper.
Although still a discrete branch of nursing, the debate around the future of the
learning disability nurse still rumbles on. A wide range of service provider agencies,
and inclusion being the key principle for people with learning disabilities in society,
has left some doubt over the future role of the learning disability nurse. The impact of
this debate is not only upon service provision but also on the future education of
learning disability nurses. Mitchell’s (1998; 2000; 2002a; 2003) work has examined
the link between social policy, service provision and education. This study is located
within this context and develops further the work of Mitchell to examine current
Government policy (Post Jay Report) to include key policy documents and reports –
Continuing the Commitment (DH, 1996) Signposts for Success (DH, 1998); Valuing
People (DH, 2001); The Health & Social care Act (DH, 2003); Choosing Health (DH,
2004); Our Health, Our Care, Our Say (DH, 2006), and the potential impact on
service provision and the future of learning disability nursing and education. The
narratives of learning disability nurses will contribute to an
understanding of the impact of said policies upon the lives and careers of learning
disability nurses in England in the past 30 years.